Weight Loss Drugs: What Are Your Options?

Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on Nov 18, 2024.

What is the newest weight loss drug?

The newest weight loss drug approved by the FDA is Zepbound (tirzepatide), a dual GIP/GLP-1 (glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1) agonist. Zepbound was approved on Nov. 8, 2023 and is given as a once-weekly subcutaneous (under the skin) injection in adults. In studies, participants lost an average of 21% of their body weight, equal to 48 lb (21.8 kg) using the 15 mg once weekly dose.

The GLP-1 (glucagon-like peptide-1) receptor agonists approved for weight loss include Wegovy (semaglutide) and Saxenda (liraglutide). They are also given by subcutaneous injection and result in significant weight loss. Wegovy and Saxenda are both used in people 12 years and older but Wegovy is injected once weekly, while Saxenda is injected once daily.

Other agents with the same active ingredients, like Ozempic (semaglutide), Mounjaro (tirzepatide) and Rybelsus (semaglutide) are approved for blood sugar control in type 2 diabetes, but have also been prescribed "off-label" for weight loss. “Off-label” means they may be prescribed by your doctor for a generally accepted use not specifically approved by the FDA or listed in package labeling.

Over the last decade, common weight loss drugs approved by the FDA include:

• Zepbound (tirzepatide): approved Nov. 8, 2023
• Wegovy (semaglutide): approved June 4, 2021
• Saxenda (liraglutide): approved Dec. 23, 2014
• Contrave (bupropion and naltrexone): approved Sept. 10, 2014
• Qsymia (phentermine and topiramate): approved July 17, 2012

Prescription weight loss drugs may be an option for adults or children who have serious health risks, such as high blood pressure, type 2 diabetes, or high cholesterol and cannot control their weight with diet and exercise alone. Medication treatment for weight loss should also include a plan for lower fat and calorie foods, as well as a regular exercise program.

Learn more: How do Ozempic, Mounjaro, Wegovy & Zepbound compare for weight loss?

There are very few proven choices in over-the-counter (OTC) or nonprescription medications for effective weight loss. One agent that is available without a prescription is alli (orlistat), a lower-dose version of the prescription drug Xenical.

Patients who are overweight or obese with any health condition should consult with their physician prior to beginning a weight loss or exercise program.

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How effective are weight loss drugs?

• Zepbound and Wegovy are both approved to be used in addition to diet and exercise for long-term weight management in adults with obesity; or overweight with weight-related medical conditions like high blood pressure, type 2 diabetes, sleep apnea, heart disease or high cholesterol.
• Wegovy is also approved for use in children 12 years and older and to help prevent major heart-related events like heart attack or stroke.
• These medicines are injected weekly as a subcutaneous injection (under the skin) and can be given at home by the patient or caregiver, after adequate training.

Zepbound

Adults

In the 72-week long SURMONT-1 study with 2,539 adults, people using Zepbound injected weekly at the 15 mg dose lost an average of 21% of their body weight (21.8 kg or 48 lb). With the lower 5 mg dose, people lost an average of 15% of their body weight (15.5 kg or 34 lb). People taking a placebo (inactive) agent lost an average of 3% of their weight, or 3.2 kg (7 lb).

The percent of patients using Zepbound that lost 5% or more of their body weight ranged from 85% to 91%, based on which dose they used. After 72 weeks of treatment, people who used Zepbound saw a statistically significant reduction in their body weight (compared with a placebo).

Zepbound is not approve for use in children under 18 years of age and has not yet received approval to help reduce the risk of major adverse cardiovascular events (like heart-related death, heart attack, or a stroke).

Wegovy

Adults

Wegovy (semaglutide) has led to an an average 15% weight loss in adults (about 35 lbs) with an average starting weight of 232 lbs. These results were seen in a 68-week long study in 1,961 adults with obesity or overweight (without type 2 diabetes), but with a weight-related medical problem like high blood pressure or high cholesterol. People taking the placebo (inactive agent) lost about 6 lbs (2.5% of their body weight). 

In March 2024, Wegovy gained another approval to reduce the risk of major adverse cardiovascular events (like heart-related death, heart attack, or a stroke) in adults with established heart disease and either obesity or overweight.

Children

Wegovy is also approved for chronic weight management in pediatric patients aged 12 years and older. In studies, a 16.1% decrease in body mass index (BMI) in children 12 years of age and older was demonstrated. 

• Approval for Wegovy in children was supported by the 68-week Phase 3a STEP TEENS clinical trial with 201 adolescents aged 12 years or older.
• Wegovy was superior to placebo in mean percent change in BMI at week 68 (16.1% decrease vs 0.6% increase) - the primary endpoint.
• In addition, the percent of children with a BMI reduction of at least 5% was 77% in the Wegovy group vs. 20% in those receiving a placebo. Body weight was reduced by close to 15% in the Wegovy group (about 16 lbs).

Saxenda

Results from a Saxenda 56-week, Phase 3 clinical trial with 3,731 participants showed that patients had an average weight loss of 4.5% of their weight compared to treatment with a placebo (inactive pill) at one year. In this trial, 62% of patients treated with Saxenda compared with 34% of patients treated with placebo lost at least 5% of their body weight. 

• Saxenda is approved to be used with diet and exercise for long-term weight management in adults with overweight (BMI ≥27 kg/m²), in the presence of at least one weight-related medical condition ( such as high blood pressure, type 2 diabetes, or elevated cholesterol levels) or obesity (BMI ≥30 kg/m²).
• Saxenda is also approved for use in adolescents 12 years and older with body weight above 60 kg (132 lb) and an initial BMI corresponding to 30 kg/m² or greater for adults (obese) by international cut-offs, in addition to a reduced calorie diet and increased physical activity.

Anorexiants

Anorexiants are drugs that act on the brain to help suppress appetite. Patients using anorexiant weight loss pills like Contrave or Qsymia may lose roughly 5% to 10% of their initial weight over one year when used as part of an effective diet and exercise plan.

If you have not lost at least 5% of your initial body weight after 12 weeks, it is unlikely that you will achieve meaningful weight loss with continued treatment, and your healthcare provider may decide to stop or switch treatment.

Table of Common Weight Loss Drugs

Many people who are trying to lose weight may choose dietary supplements or herbal medications, but most of these products have not been adequately studied for effectiveness or safety. None are approved by the U.S. Food and Drug Administration (FDA) for weight loss. Check with a healthcare provider for advice before using herbal or dietary supplements for weight loss.

Who Should Use Weight Loss Drugs?

Generally, most people should initially try to lose weight using diet and exercise. Prescription diet drugs may be used as "second-line" treatment, when weight loss has not been successful and the patient has important health risks associated with being overweight or obese.

Weight loss drugs are usually indicated for obese patients, or overweight patients with the presence of other risk factors (such as high blood pressure, type 2 diabetes, high cholesterol / lipids, sleep apnea). Talk with your doctor about your eligibility for one of these treatments..

In many cases, people with type 2 diabetes who are treated with a GLP-1 agonist or GIP/GLP-1 agonist will lose significant weight while also achieving adequate blood sugar levels, a positive benefit from treatment.

Many weight loss medicines are not covered by health insurance, may have a high copay or be part of a "stepped-therapy" plan, meaning you have try other weight loss options first, so check with your prescription plan.

Some people with established cardiovascular disease and either obesity or overweight who are in Medicare Part D or Medicaid programs may be eligible for Wegovy (semaglutide) now that it has been approved for a cardiovascular risk reduction indication, according to the Centers for Medicare and Medicaid Services (CMS).

Always review the warnings, precautions and side effects of the new GLP-1 / GIP weight loss drugs with your healthcare provider.

• Be sure to let them know that you are taking one of these medicines (like Ozempic, Wegovy, Rybelsus, Zepbound or Mounjaro) before you are scheduled to have surgery or other procedures.
• All GLP-1 receptor agonists like semaglutide and tirzepatide now have a warning for a rare increased risk of lung aspiration (food or liquid getting into your lungs) during deep sedation or general anesthesia used for procedures or surgery. 
• It is thought lung aspiration may occur because these drugs slow down stomach emptying, and even if you fast (avoid eating / drinking) as directed before surgery you may still have food or liquid left in your stomach, which could be inhaled into your lungs while under sedation or general anesthesia.

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Plenity for Weight Loss

In April 2019, the FDA approved Plenity to aid in weight management, in conjunction with diet and exercise, in overweight and obese adults with a Body Mass Index (BMI) of 25 to 40 kg/m².

• Plenity is an oral, non-systemic capsule that contains hydrogel particles that absorb water and expand in the stomach leading to a feeling of fullness.
• In a placebo-controlled study of Plenity in 436 overweight or obese adults, the primary endpoint was achieved with 59% of adults in the treatment group achieving weight loss of 5% or greater after six months.
• There were no statistical differences in side effects between treatment groups, which primarily included stomach side effects (fullness, bloating, flatulence, and/or abdominal pain).

Your doctor is always your primary medical expert; however, you might consider joining the Drugs.com Weight Loss Support Group to discover others with similar questions and shared health values. 

This is not all the information you need to know about weight loss or drug treatment for weight loss and does not take the place of your doctor’s directions. Discuss any medical questions you have with your doctor or other health care provider.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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